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NOVA PLASTIC SURGERY LLC NPI 1992094494


NPI Information

NPI: 1992094494
Provider Name: NOVA PLASTIC SURGERY LLC
Classification: Plastic Surgery - 208200000X
Entity Type: Organization

CLIA Number: 49D2229097

Address:
1860 TOWN CENTER DR
SUITE 255
RESTON, VA
ZIP 20190
Phone: (703) 574-2588
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NOVA PLASTIC SURGERY LLC is a plastic surgery in Reston, VA. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. NOVA PLASTIC SURGERY LLC NPI is 1992094494. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1860 TOWN CENTER DR
SUITE 255
RESTON, VA
ZIP 20190-896
Phone: (703) 574-2588
Fax: (703) 574-3648

The provider's authorized official is Fadi Nukta .
The authorized official title is Managing Member and has the following contact phone number (703) 574-2588.

The CLIA number assigned to this NPI record is 49D2229097 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/5/2011 and was last updated on 12/8/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208200000XPlastic Surgery0101248274VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1001246101MEDICARE PINMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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